You are the expert of you
I grew up in the age when the physician knew all. Much like Spock, they were trained in the Vulcan Mind Meld. You never had to tell them anything. They just divined the answer. Therefore, we (patients) were trained not to question anything or add to the conversation. We were programmed to be “the ideal” patient in the office by not questioning the physician. However, once we left the office, we did what we wanted to do. So, it’s no surprise, that we didn’t follow the instructions and that our health outcomes didn’t improve.
So, what does patient engagement really mean?
“Patient engagement is a concept that combines a patient’s knowledge, skills, ability, and willingness to manage his own health and care with interventions designed to increase activation and promote positive patient behavior.”
— Health Affairs Brief, 2013
Sounds like Romulan to me.
What patient engagement means to me is a willingness to question, share my thoughts or concerns, and to try the agreed upon intervention, or plan of care. It’s really a dialogue between my provider and me about understanding the issue, looking at the pros and cons of the treatment, and finding something I’m willing to try. Once I’ve had that conversation, then it’s up to me to follow through and give the plan a try. What I want from my provider is a willingness to listen, question, and fully interact with me.
The conversation might go something like this:
Provider: Brenda, you need to stop smoking.
Me: Yeah, yeah……..I know, but I like it. It relaxes me, gives me a break, keeps me from gaining weight. We have this conversation every year.
Provider: Your lungs are showing signs of COPD. This means you’re not getting the oxygen you need, and it will get worse with continued smoking. What would it take for you to consider quitting?
Me: I wouldn’t want to gain weight, that’s the most important thing to me.
Provider: I could refer you to a class that some of my patients have had success with. They promote tips for managing your weight and stress while stopping smoking. There is also a medication that we could try, there are some reports that it may help to control your appetite as well as your desire to smoke. Do you think you might be willing to try one or both of these?
Me: If you think the drug will help, I’m willing to try it.
Provider: OK, that’s great. I’ll have you come back in two weeks and we’ll see how you are doing.
As Dr. Elizabeth Marshall says, “You are the expert of you.” No one knows you as well as you know yourself. Speak up. Advocate for yourself. Be honest with what you are willing to do. Be sure you understand what your provider said. Don’t worry about looking foolish. It’s by far better to clarify than to guess after the fact. If your provider is speaking Romulan, ask them to say it in English. If you are worried about the cost, ask how expensive it is; there may be alternative treatments that are less expensive.
Being an engaged patient is about participating.
- Don’t be passive.
- Ask for what you need.
- Have a meaningful conversation and make a commitment.
Then, look for ways to support that commitment. Perhaps an alarm that reminds you to take a pill, a friend that picks you up for a walk, reading a wellness blog to encourage personal health, or an app that logs your food intake. There are no magic pills. It all comes down to each of us, our desire to make the change and our efforts to sustain the change.
Live long and prosper….in good health.
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